CA2641947A1 - Surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence - Google Patents

Surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence

Info

Publication number
CA2641947A1
CA2641947A1 CA 2641947 CA2641947A CA2641947A1 CA 2641947 A1 CA2641947 A1 CA 2641947A1 CA 2641947 CA2641947 CA 2641947 CA 2641947 A CA2641947 A CA 2641947A CA 2641947 A1 CA2641947 A1 CA 2641947A1
Authority
CA
Grant status
Application
Patent type
Prior art keywords
surgical instrument
characterized
body
tape
surgical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA 2641947
Other languages
French (fr)
Inventor
Torelli Donato Piroli
Mario Polichetti
Original Assignee
Torelli Donato Piroli
Pipo Llc
Mario Polichetti
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/0004Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse
    • A61F2/0031Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra
    • A61F2/0036Closure means for urethra or rectum, i.e. anti-incontinence devices or support slings against pelvic prolapse for constricting the lumen; Support slings for the urethra implantable
    • A61F2/0045Support slings
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/06Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
    • A61B17/062Needle manipulators
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00805Treatment of female stress urinary incontinence
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/062Measuring instruments not otherwise provided for penetration depth

Abstract

A surgical instrument (1) for correcting hypermotility of the female urethra in exertional urinary incontinence, comprising a rod-like body (1a) provided with a first rounded end (2) and a second rounded opposite end (3) provided with a slit (4).

Description

SURGICAL INSTRUMENT FOR CORRECTING HYPERMOTILITY OF
THE FEMALE URETHRA IN EXERTIONAL URINARY
INCONTINENCE

Technical Field The present invention relates to a surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence. More particularly, the invention relates to a surgical instrument adapted to perform a surgical operation for correcting hypermotility of the female urethra so as to eliminate substantially the disorder of exertional urinary incontinence.

Background Art As is known, exertional urinary incontinence, i.e., the irivoluntary leakage of urine following exertion, such as for example coughing, lifting a weight, and in general whenever abdominal pressure increases for any reason, is a problem which can be corrected surgically.
One of the surgical procedures currently used consists in inserting, beneath the female middle urethra, a small polypropylene tape, which is passed through the obturator membrane of either side up to the skin (T.O.T.). The tape is approximately 1 cm thick and has several forms of weave.
The instrument currently used to perform the surgical procedure for positioning the tape consists of a channeling or tunneling tool, constituted by a helical- needle with any curvature, which is mounted on a handpiece which allows to use it. Such devices can be of the right-handed and left-handed type, depending on the anatomical part to be crossed. One end of the helical needle is rounded and allows the engagement of the polypropylene tape in order to pass below the middle female urethra and is made to exit through the obturator membrane of both sides from the skin.
The instrument described above forces to perform the surgical procedure practically blindly, with the possibility of the onset of several severe complications for the patient. Since the procedure, as mentioned, is performed blindly, patients may suffer vascular arterial and venous complications, which moreover can be diagnosed late, in addition to bladder, vaginal and rectal nervous lesions with the possibility of fistulas.

Disclosure of the Invention The aim of the present invention is to provide a surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence which allows to minimize the risks linked to the surgical procedure performed by using said instrument.

Within this aim, an object of the present invention is to provide a surgical instrument for correcting hypermotility of the female urethra which allows to measure precisely the distance from the urethra to the ischiopubic ramus, in order to be able to cut the tape to the required size.
Another object of the present invention is to `provide a surgical instrument which allows to prepare two bilateral vaginal tunnels in which the ends that are distal with respect to the urethra are narrower than the proximal ends.
Still another object of the present invention is to provide a surgical instrument which is highly reliable, relatively simple to provide and at competitive costs.
This aim and these and other objects, which will become better apparent hereinafter, are achieved by a surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence, characterized in that it comprises a rod-like body provided with a first convex rounded end and a second concave rounded opposite end which is provided with a slit.

Brief Description of the Drawings Further characteristics and advantages of the invention will become better apparent from the description of preferred but not exclusive embodiments of the surgical instrument according to the present invention, illustrated by way of non-limiting example in the accompanying drawings, wherein:
Figure 1 is a perspective view of a first embodiment of the surgical instrument according to the present invention;
Figure 2 is a perspective view of a second embodiment of the surgical instrument according to the present invention;
Figure 3 is a view of a third embodiment of the surgical instrument according to the present invention;
Figure 4 is a view of an embodiment of a tape which can be used with the surgical instrument according to the present invention.

Ways of carrying out the Invention With reference to the Figures, the surgical instrument according to the present invention, generally designated by the reference numeral 1, comprises a rod-like body 1 a, conveniently made for example of sterilizable plastic material, which has a first rounded convex end 2 and a second concave end 3 which is also rounded and provided with a slit 4 which allows the engagement of a mesh of the tape.
The convex end of the body of the surgical instrument has a dual function:
to measure precisely the distance from the urethra to the ischiopubic ramus, or to the preset point, in order to be able to cut a tape 10 to the required size;
to prepare two bilateral vaginal tunnels, in which the ends arranged distally with respect to the urethra are narrower than the proximal ends.

The concave end of the surgical instrument is instead designed to engage the tape in order to be able to insert it in the tunnels prepared previously and give the tape the required tension.
Conveniently, the body of the surgical instrument has a plurality of notches (starting from the convex end and mutually spaced for example by half a centimeter for a total of six centimeters) intended to indicate to the surgeon the size of the tape to be inserted. Such notches are conveniently applied on both sides of the instrument.
Conveniently, the surgical instrument can be provided by means of a body, as shown in Figure 1, in which a convex end is curved with respect to the remaining portion of the body, or it can be as shown in Figure 2, in which both ends, the convex one 2 and the concave one 3, are curved upwardly, or also as shown in Figure 3, in which the body of the surgical instrument is S-shaped, with the convex end 2 and the concave end 3 curved respectively in opposite directions.
Moreover, the body of the surgical instrument 1 can be provided for example in straight form, not shown in the figures.
Conveniently, the surgical instrument has a diameter of for example 0.3 centimeters at its two ends and of 0.5 centimeters at the center, with a length ranging from 12 to 15 centimeters.
These measurements are of course merely an indication and may be changed according to the requirements.
The use of the surgical instrument according to the invention is as follows.
After disinfection of the area concerned, a linear incision of approximately 1 centimeter is produced starting approximately 1.5 centimeter below the urethral meatus. By means of the surgical instrument according to the invention, which is used only on the convex part, two channels are provided below the vaginal mucous membrane under the urethra until the two ischiopubic rami are touched bilaterally.

The tunnels thus formed are designed to accommodate a tape 10 with the weft for example as shown in Figure 4, which is adapted to be engaged by the concave end of the surgical instrument and arranged transversely below the urethra so as to produce a supporting surface for the urethra proper.
At this point, by means of simple and completely nontraumatic maneuvers, the tape can be given the required tension after trimming it to size, by means of the graduated scale 5, 6, 7 arranged on the body of the surgical instrument. The small vaginal breach is then sutured and wadding is positioned and removed a few hours later.

5 Conveniently, the tape is provided with tight lateral meshes 11 and with relatively wider central meshes 12, so as to allow the engagement of the portion of the concave end 3 provided with the slot or slit 4 of the surgical instrument.
The surgical instrument thus conceived is susceptible of numerous modifications and variations, all of which are within the scope of the appended claims.
Thus, for example, the tape may be cylindrical in addition to the flat shape shown in Figure 4.
All the details may further be replaced with other technically equivalent ones.
In practice, the materials used, as well as the contingent shapes and dimensions, may be any according to requirements and to the state of the art.
The disclosures in Italian Patent Application No. MI2006A000228 from which this application claims priority are incorporated herein by reference.

Claims (12)

1. A surgical instrument (1) for correcting hypermotility of the female urethra in exertional urinary incontinence, characterized in that it comprises a rod-like body (1 a) provided with a first convex rounded end (2) and a second concave rounded opposite end (3) which is provided with a slit (4).
2. The surgical instrument according to claim 1, characterized in that said rod-like body (1a) is straight.
3. The surgical instrument according to claim 1, characterized in that said rod-like body (1a) has its convex end (2) curved with respect to the rest of the body.
4. The surgical instrument according to one or more of the preceding claims, characterized in that said concave end (3) and said convex end (2) are curved with respect to the remaining portion of the rod-like body (1a).
5. The surgical instrument according to one or more of the preceding claims, characterized in that said concave (3) and convex (2) ends are curved in opposite directions.
6. The surgical instrument according to one or more of the preceding claims, characterized in that it comprises, at the body of the instrument, a plurality of notches (5,6,7) which are adapted to provide an indication of the measurement of a tape (10) which must be cut to size by a surgeon.
7. The surgical instrument according to claim 6, characterized in that said notches (5,6,7) are provided at at least one side of the body (1a) of the instrument.
8. The surgical instrument according to claim 6, characterized in that said tape (10) is substantially flat.
9. The surgical instrument according to claim 6, characterized in that said tape (10) is substantially cylindrical.
10. A surgical kit for correcting hypermotility of the female urethra in exertional urinary incontinence, comprising:
two surgical instruments (1) according to one or more of the preceding claims; and a tape (10) provided with lateral meshes (11) which are tighter than central meshes (12).
11. The surgical kit according to claim 10, characterized in that said tape (10) is substantially flat.
12. The surgical kit according to claim 10, characterized in that said tape (10) is substantially cylindrical.
CA 2641947 2006-02-09 2006-11-02 Surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence Abandoned CA2641947A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
ITMI2006A000228 2006-02-09
ITMI20060228 2006-02-09
PCT/EP2006/010541 WO2007090446A8 (en) 2006-02-09 2006-11-02 Surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence

Publications (1)

Publication Number Publication Date
CA2641947A1 true true CA2641947A1 (en) 2007-08-16

Family

ID=37801402

Family Applications (1)

Application Number Title Priority Date Filing Date
CA 2641947 Abandoned CA2641947A1 (en) 2006-02-09 2006-11-02 Surgical instrument for correcting hypermotility of the female urethra in exertional urinary incontinence

Country Status (4)

Country Link
US (1) US20090030265A1 (en)
EP (1) EP1981430A1 (en)
CA (1) CA2641947A1 (en)
WO (1) WO2007090446A8 (en)

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3640281A (en) * 1970-01-02 1972-02-08 Jack R Robertson Method of inserting a suprapubic catheter
US5019032A (en) * 1990-04-03 1991-05-28 Robertson Jack R Refined suspension procedure with implement for treating female stress incontinence
US6911003B2 (en) * 2002-03-07 2005-06-28 Ams Research Corporation Transobturator surgical articles and methods
US7357773B2 (en) * 2002-03-07 2008-04-15 Ams Research Corporation Handle and surgical article
WO2003075792A9 (en) * 2002-03-07 2004-03-04 Ams Res Corp Transobturator surgical articles and methods
EP1784141B1 (en) * 2004-07-28 2011-10-12 Ethicon, Inc. Minimally invasive medical implant and insertion device
US7527588B2 (en) * 2004-09-15 2009-05-05 Ethicon, Inc. System and method for surgical implant placement

Also Published As

Publication number Publication date Type
US20090030265A1 (en) 2009-01-29 application
EP1981430A1 (en) 2008-10-22 application
WO2007090446A1 (en) 2007-08-16 application
WO2007090446A8 (en) 2007-10-11 application

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Legal Events

Date Code Title Description
FZDE Dead